Endodontics Flashcards
Discuss the pulp of a tooth in regards to each of the following:
- What does the pulp contain?
- What 3 different cells are in the pulp?
The pulp contains loose fibrous CT w/ nerves, blood vessels, and lymphatics.
Pulpal Cells: Fibroblasts, odontoblasts, undifferentiated mesenchymal cells
Which of the following secretes dentin?
A. Fibroblasts
B. Odontoblasts
C. Undifferentiated mesenchymal cells
D. All of the above
E. None of the above
B. Odontoblasts
Which of the following secretes fibrous connective tissue?
A. Fibroblasts
B. Odontoblasts
C. Undifferentiated mesenchymal cells
D. All of the above
E. None of the above
A. Fibroblasts
Which of the following is secreted BEFORE root formation is complete?
A. Primary dentin
B. Secondary dentin
C. Tertiary dentin
D. Quaternary dentin
A. Primary dentin
Primary dentin = before root formation is complete
Secondary dentin = after root formation is complete
Tertiary denting = in response to pulpal injury
Which of the following secretes tertiary dentin?
A. Fibroblasts
B. Odontoblast
C. Secondary odontoblasts
D. Undifferentiated mesenchymal cells
C. Secondary odontoblasts
Which of the following secreted Secondary dentin?
A. Fibroblasts
B. Odontoblast
C. Secondary odontoblasts
D. Undifferentiated mesenchymal cells
B. Odontoblast
How does the anatomy of the pulp make it more prone to infection?
- Surrounded by hard dentin which limits its ability to expand (if an infection is present the pulp is not able to expand against the hard dentin surrounding it)
- Lacks collateral circulation which limits its ability to cope with infection (one way in and one way out) - less avenues for immune cells to get into the pulp to help
How does the pulp defend against infection? (4 ways)
Which of the following is a reaction to minor damage?
A. Sclerotic dentin
B. Reactionary dentin (2ndary dentin)
C. Reparative dentin (tertiary dentin)
D. Pulpal necrosis
B. Reactionary dentin (2ndary dentin)
Reactionary dentin = minor damage
Reparative dentin = major damage
Which of the following is a reaction to major damage?
A. Sclerotic dentin
B. Reactionary dentin (2ndary dentin)
C. Reparative dentin (tertiary dentin)
D. Pulpal necrosis
C. Reparative dentin (tertiary dentin)
Which of the following is in response to rapidly advancing caries or other severe damage?
A. Sclerotic dentin
B. Reactionary dentin (2ndary dentin)
C. Reparative dentin (tertiary dentin)
D. Pulpal necrosis
D. Pulpal necrosis
What are the 5 histologic zones of the pulp?
All of the following are true regarding A fibers of the pulp EXCEPT:
A. Large myelinated afferent nerve
B. Course centrally in the pulp
C. Responsible for sharp transient “first pain”
D. Responsible for cold sensation
E. All of the above are true
B. Course centrally in the pulp
Note: makes sense that A fibers are responsible for sharp transient pain bc they are large myelinated nerves (making the impulse faster)
All of the following are true regarding C fibers of the pulp EXCEPT:
A. Small unmyelinated afferent nerve
B. Course centrally in the pulp
C. Responsible for sharp transient “first pain”
D. Responsible for heat sensation
E. All of the above are true
C. Responsible for sharp transient “first pain”
Note: makes sense that C fibers are responsible for dull throbbing pain bc they are small unmyelinated nerves (slower than large myelinated nerves)
All of the following are true regarding C fibers of the pulp EXCEPT:
A. Small unmyelinated afferent nerve
B. Course coronally in the pulp
C. Responsible for dull throbbing “second pain”
D. Responsible for heat sensation
E. All of the above are true
B. Course coronally in the pulp
Which of the following course centrally in the pulp?
A. A fibers
B. C fibers
B. C fibers
Which of the following is a heightened response to pain?
A. Hyperalgesia
B. Allodynia
A. Hyperalgesia
Note: something that’s usually painful becomes even more painful due to inflammatory mediators (hyperalgesia)
Which of the following refers to pain due to stimulus that does NOT normally provoke pain?
A. Hyperalgesia
B. Allodynia
B. Allodynia
Eg. Sunburn… usually touching your skin doesn’t hurt. It hurts to touch your skin if you’re sunburnt. Aloe helps w/ sun burn. (This is a way to remember Allodynia = Aloe-dynia
***BOARDS***
Preauricular pain often refers from _______.
A. Maxillary incisors
B. Mandibular incisors
C. Maxillary molars
D. Mandibular molars
D. Mandibular molars
note: Preauricular pain often refers from mandibular molars since both share V3 innervation.
***BOARDS***
All of the following are true regarding Symptomatic Irreversible Pulpitis EXCEPT:
A. Pulp has been irreversibly damaged beyond repair; even w/ removal of the irritant it will not fully heal
B. Thermal (often cold) stimulus causes lingering pain
C. Postural changes like bending over or lying down exacerbate dental pain
D. Characterized by spontaneous intermittent or continuous pain
E. All of the above are true
E. All of the above are true
Discuss the pulpal diagnosis: Normal Pulp:
Discuss the pulpal diagnosis Reversible Pulpitis:
Discuss the pulpal diagnosis Symptomatic Irreversible Pulpitis:
Discuss the pulpal diagnosis Asymptomatic Irreversible Pulpitis:
Discuss the pulpal diagnosis Pulp Necrosis:
What are the 5 Periapical Diagnosis?
- Normal apical tissues
- Symptomatic apical periodontitis
- Asymptomatic apical periodontitis
- Acute apical abscess
- Chronic apical abscess
Which of the following is asymptomatic; no pain on percussion or palpation?
A. Normal apical tissues
B. Symptomatic Apical periodontitis
C. Asymptomatic apical periodontitis
D. Acute apical abscess
E. Chronic apical abscess
A. Normal apical tissues
Which of the following is characterized by a draining sinus tract w/o discomfort?
A. Normal apical tissues
B. Symptomatic Apical periodontitis
C. Asymptomatic apical periodontitis
D. Acute apical abscess
E. Chronic apical abscess
E. Chronic apical abscess
Which of the following is characterized by painful percussion and intense throbbing pain?
A. Normal apical tissues
B. Symptomatic Apical periodontitis
C. Asymptomatic apical periodontitis
D. Acute apical abscess
E. Chronic apical abscess
B. Symptomatic Apical periodontitis
Note: localized inflammatory infiltrate within the PDL
Which of the following is characterized by rapid swelling, severe pain and purulent exudate around apex?
A. Normal apical tissues
B. Symptomatic Apical periodontitis
C. Asymptomatic apical periodontitis
D. Acute apical abscess
E. Chronic apical abscess
D. Acute apical abscess
Which of the following is characterized as asymptomatic w/ an apical radiolucency?
A. Normal apical tissues
B. Symptomatic Apical periodontitis
C. Asymptomatic apical periodontitis
D. Acute apical abscess
E. Chronic apical abscess
C. Asymptomatic apical periodontitis
Discuss percussion and palpation in regards to periapical diagnosis:
Which of the following is the least reliable pulpal vitality test?
A. Cold test
B. EPT
B. EPT
Discuss the Cold Test vs EPT:
Which of the following indicates if there are vital sensory fibers present in the pulp, but does NOT provide any information about vascular supply to the pulp?
A. Cold test
B. EPT
B. EPT
What is the chemical formula for endo ice?
Dichlorodifluoromethane
All of the following are true regarding Access Preparartion for RCT EXCEPT:
A. Most important technical aspect of RCT
B. Conservation of tooth structure
C. Deroof chamber to expose pulp horns and orifices
D. Straight-line access to orifice and apex
E. All of the above are true
E. All of the above are true
Which of the following has a trapezoidal access shape for RCT?
A. Incisors
B. Canines
C. Premolars
D. Maxillary molars
E. Mandibular molars
E. Mandibular molars
Note: mandibular molars have two roots… The distal root contains 2 canals (mandibular molars usually contain 3 canals)
Incisors = Triangle
Canines = Oval (ovoid)
Premolars = Oval (ovoid)
Maxillary molars = Blunted triangle / Rhomboid
Mandibular molars = Trapezoidal
Which of the following has a triangular access shape for RCT?
A. Incisors
B. Canines
C. Premolars
D. Maxillary molars
E. Mandibular molars
A. Incisors
Note: triangular prep to remove pulp horns, and helps to prevent marginal ridges
Incisors = Triangle
Canines = Oval (ovoid)
Premolars = Oval (ovoid)
Maxillary molars = Blunted triangle / Rhomboid
Mandibular molars = Trapezoidal
Which of the following has a blunted triangular or rhomboid access shape for RCT?
A. Incisors
B. Canines
C. Premolars
D. Maxillary molars
E. Mandibular molars
D. Maxillary molars
***BOARDS***
Incisors = Triangle
Canines = Oval (ovoid)
Premolars = Oval (ovoid)
Maxillary molars = Blunted triangle / Rhomboid
Mandibular molars = Trapezoidal
Which of the following has a ovoid (oval) access shape for RCT?
A. Incisors
B. Canines
C. Premolars
D. Maxillary molars
E. Mandibular molars
B. Canines AND C. Premolars
Incisors = Triangle
Canines = Oval (ovoid)
Premolars = Oval (ovoid)
Maxillary molars = Blunted triangle / Rhomboid
Mandibular molars = Trapezoidal
Which premolar has two roots?
A. Maxillary 1st PM
B. Maxillary 2nd PM
C. Mandibular 1st PM
D. Mandibular 2nd PM
A. Maxillary 1st PM
***BOARDS***
Which of the following contains a 0.4 or 0.6 taper?
A. SS hand files
B. K-file (Kerr)
C. H-file (Hedsrtom)
D. NiTi rotary instruments
D. NiTi rotary instruments
Which of the following contains a 0.2 taper?
A. SS hand files
B. K-file (Kerr)
C. H-file (Hedsrtom)
D. NiTi rotary instruments
A. SS hand files
B. K-file (Kerr)
C. H-file (Hedsrtom)